Wiki Office Visit and Hearing Test

[Apowers6033@email.vccs.edu]

If a patient presents to the office for hearing loss. The patient is assessed an audio and tympanogram is performed. Final diagnosis is H69.83 (eustachian tube dysfunction). How would you bill the claim?
Our provider went to a coding class and is saying we can only bill for the office visit. However, from what I can find I believe we would be able to bill the office visit as well as the audio and tympanogram.
Her theory is you can only bill one CPT for each diagnosis and since you only have H69.83 you would not be able to bill for the office visits.

Anyone have experience that can offer insight?

 

[lgardner]

If a patient presents to the office for hearing loss. The patient is assessed an audio and tympanogram is performed. Final diagnosis is H69.83 (eustachian tube dysfunction). How would you bill the claim?
Our provider went to a coding class and is saying we can only bill for the office visit. However, from what I can find I believe we would be able to bill the office visit as well as the audio and tympanogram.
Her theory is you can only bill one CPT for each diagnosis and since you only have H69.83 you would not be able to bill for the office visits.

Anyone have experience that can offer insight?

This will entirely depend on the documentation.

It is not true that you can only bill one CPT per dx (at least not nowadays), BUT the documentation must support an E/M that is above and beyond what is included with the procedure.

In my opinion, if the documentation did not meet the criteria for both, I would bill the procedure only, since that is why the patient came in